Coronavirus disease 2019 (COVID-19) is a pandemic disease resulting from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, primarily in the respiratory tract. This pandemic disease has affected the entire world, and the pathobiology of this disease is not yet completely known. The Interactions of SARS-CoV-2 proteins with different cellular components in the host cell may be necessary for understanding the disease mechanism and identifying crucial pharmacological targets in COVID-19. Studies have suggested that the effect of SARS-CoV-2 on other organs, including the brain, maybe critical for understanding the pathobiology of COVID-19. Symptoms in COVID-19 patients, including impaired consciousness dizziness, headache, loss of taste and smell, vision problems, and neuromuscular pain, suggest that neuronal complications comprise a crucial component of COVID-19 pathobiology. A growing body of literature indicates that SARS-CoV-2 can enter the brain, leading to neuronal defects in COVID-19 patients. Other studies suggest that SARS-CoV-2 may aggravate neuronal complications due to its effects on the cerebrovascular system. Emerging pieces of evidence show that stroke can be one of the leading neurological complications in COVID-19. In this review, we describe the observations about neuronal complications of COVID-19 and how SARS-CoV-2 may invade the brain. We will also discuss the cerebrovascular problems and occurrence of stroke in COVID-19 patients. We will also present the observations and our views about the potential pharmacological strategies and targets in COVID-19. We hope this review will help comprehend the current knowledge of neuronal and cerebrovascular complications from SARS-CoV-2 infections and highlight the possible long-term consequences of SARS-CoV-2 on the human brain.
The dual pandemics of coronavirus disease-19 (COVID-19) and diabetes among patients are associated with 2- to 3-times higher intensive care admissions and higher mortality rates. Whether sheltering at home, quarantined with a positive COVID-19 test, or hospitalized, the person living with diabetes needs special considerations for successful management. Having diabetes and being COVID-19–positive increases the risk of poor outcomes and death. Providers need to give anticipatory pharmacologic guidance to patients with diabetes during COVID-19 lockdown. Patients with diabetes need to be more observant than others and to use self-protective actions. This review (1) discusses the clinical observations of COVID-19, diabetes and underlying mechanisms, (2) describes special considerations in caring for patients with diabetes in a COVID-19 environment, and (3) reviews clinical implications for the health care provider. This review highlights current evidenced-based knowledge. Additional research regarding clinical management is warranted
PurposePhysical inactivity is one of the important factors leading to chronic diseases including cardiovascular disease (CVD) in individuals with disabilities. However, not many Physical Activity (PA) interventions are available for improving the efficacy of PA and cardiovascular outcomes among community wheelchair users. Therefore, this systematic review will appraise the existing PA interventions for the community dwelling wheelchair users; we especially examined features of the PA programs that showed the improvements in PA and the CVD outcomes compared to the interventions that did not show any improvements in these outcomes among these population. The study also aimed to provide some recommendations for future research.Materials and MethodsA comprehensive and systematic search of literature published between 2015 and 2020 using the databases Scopus, Pubmed, Embase, and Cochrane CENTRAL was conducted. This review has followed the Preferred Reporting Items for Systematic Review (PRISMA) guidelines. The quality of the evidence was assessed by Using Joanna Briggs Institute's critical appraisal tool. Studies that tested the efficacy of PA interventions for community-dwelling adult wheelchair users and published in English were involved. Two reviewers reviewed the literature and any disagreements among these reviewers were resolved by a third reviewer.ResultsFourteen articles were selected for this review. Most of the studies reported improvements in PA. A few studies followed up the participants and majority of the studies have looked at the CVD outcomes.ConclusionLarge-scale studies with follow-ups, and community participatory research that evaluates the effect of PA interventions on PA and CVD outcomes among wheelchair users are needed.
Introduction: Depression is a risk factor for stroke; however, the impact of changes in the level of depressive symptoms on the risk of incident stroke is less well described. Methods: The study included participants from REGARDS, a national longitudinal cohort study of 30,239 Black and White adults aged ≥ 45 years at baseline 2003-2007. Depressive symptoms were assessed longitudinally using the 4-item Center for Epidemiologic Studies Depression Scales (CES-D-4), and scores of 4+ were categorized as “high.” Over up to 18 years of follow-up, for each participant with each serial assessment, we categorized the transition in depression as moving from low to low (LL), low to high (LH), high to low (HL), and high to high (HH), and used Cox regression to assess stroke risk subsequent to the transition, with incremental adjustment for risk factors. Results: Among 20,691 participants, we observed over 80,447 transitions in depressive symptom level and 832 incident strokes. Participants in the HH group had a higher risk for stroke compared to the LL group in both unadjusted {[HR] = 1.46, 95% confidence interval (CI) = 1.08–1.97}, and adjusted models, regardless of adjustment for demographics [HR] = 1.63, (CI = 1.21–2.20), plus SES [HR] = 1.50, (CI = 1.11–2.03), and stroke risk factors [HR] = 1.38, (CI = 1.01–1.90). However, full adjustment attenuated the effect. In both unadjusted and adjusted models, participants in the LH group were at marginally higher risk than LL and those in the HL group had a low risk like that of the LL group (see Table). Conclusion: Transition in levels of depression symptoms directly impacts the risk for stroke. Screening and intervention delivery for depressive symptoms may consider the level of symptoms as a dynamic process.
Building and sustaining a robust program of research as an early career scientist requires intentional and strategic effort. Scientists begin careers with passion and dedication to ensure their work will have an impact on the communities that they serve. However, the formula to achieve meaningful and sustained research and career results often seems elusive. While there are no cookiecutter approaches guaranteeing timely transition to independent research, consistent application of several universal strategies may increase chances of success, limit frustration, and promote work-life balance. | DEFINE YOUR NICHEProperly defining a research niche is the foundation for building and sustaining a robust program of research. Defining what makes one's research and scholarship trajectory different, timely, addressing realworld issues, and the potential impact, if successful are key building blocks. Defining a research niche informs all other aspects of career progression, including the research strategic plan, what mentors to seek out, potential collaborators, training opportunities to pursue, and the type of grant funding to seek.
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